Accepted Manuscript RE: Letter: A comparison of short-term surgical outcomes between NHS and private sector abdominoplasty surgery Alan G.A. Weir , MRCS PII:

S1748-6815(14)00227-7

DOI:

10.1016/j.bjps.2014.05.011

Reference:

PRAS 4194

To appear in:

Journal of Plastic, Reconstructive & Aesthetic Surgery

Received Date: 7 May 2014 Accepted Date: 10 May 2014

Please cite this article as: Weir AGA, RE: Letter: A comparison of short-term surgical outcomes between NHS and private sector abdominoplasty surgery, British Journal of Plastic Surgery (2014), doi: 10.1016/ j.bjps.2014.05.011. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT RE: Letter: A comparison of short-term surgical outcomes between NHS and private sector abdominoplasty surgery

Sir – We note the comments made by Mr Nathan and colleagues and thank the journal

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for allowing us to respond. All abdominoplasty procedures in this study were consecutive with the aim to provide a “snapshot” of outcomes. All patients considered for abdominoplasty procedure in the private sector were advised not

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to smoke by both the senior author and private hospital. This was a matter of routine but unfortunately not always recorded in the medical notes as it formed

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part of the pre-assessment process as well as advice sheets given to patients. The senior author has made it his practice not to operate on patients who smoke more than five cigarettes per day and ensures those that do are fully aware of the

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associated increased risks.

With regards to seromas, only three in the NHS cohort developed a seroma but

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these may have been underreported as documentation was sometimes variable. This was not the case in the private cohort where the senior author reviewed

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every patient at every visit. In the private cohort 4 patients required drainage of seroma. Of these 4 patients 3 required no more than two drainage procedures as the senior author uses steroid in the seroma cavity to help reduce recurrence. The final patient had a complex abdominal wall with multiple scars and required multiple aspirations eventually developing a pseudocyst requiring surgical excision. This patient was responsible for 44 post op visits which included appointments for other procedures too.

ACCEPTED MANUSCRIPT The long follow up for the NHS cohort was due to massive weight loss patients who were seen repeatedly for ongoing management and other surgical procedures, with abdominoplasty being only one intervention. Our data were not able to discriminate the exact reason for follow up so all were included. We hope

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that this provides further detail to augment the data originally presented.

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Alan G A Weir MRCS

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[email protected]

Re: letter: a comparison of short-term surgical outcomes between NHS and private sector abdominoplasty surgery.

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